A hole can form in this membrane from a severe ear infection; an ear tube; or from an injury, such as an object poking in the ear canal. A child may notice this hole if he blows his nose and hears air comes out, if he experiences hearing loss, or if he sees fluid has drained onto his pillow overnight.

In about 90 percent of cases, a hole in the eardrum heals without treatment. Holes that don’t close on their own within three months are vulnerable to infections and may cause temporary hearing loss. In these cases, surgery is required.